Lack of surgical training and its impact on employee morale

For any organisation, we know that employees contribute to the success of the company when they are trained to perform their jobs according to industry standards. Training, which is essential for management as well as staff, typically consists of several classes onsite or at a different location during orientation. Some companies consider in-depth training an unnecessary expense and expect new employees to learn on the job from supervisors and older employees. However, this type of training is often inadequate and creates problems for the business. For hospitals, there are other forces at play. Coming in as a new consultant, the NHS has quite different requirements and expectations, and not everyone is ready to take on the challenges.

Unhappy Employees (sound familiar in the NHS!?)

In general, employees are interested in performing their jobs well to advance the company, feel a sense of pride for a job well done and advance to higher positions. When there is no training, employees do not understand how to do their jobs and none of these goals are possible. This leads to low morale among workers, which results in employee turnover. A company with a reputation for high employee turnover is also unattractive to potential job candidates. For the NHS and for private healthcare providers, it also means suboptimal patient care, but more on that later.

Low Production

The rate of production is low when employees don’t know enough to perform their jobs confidently. To save time, employers often delegate the task of training to employees who have been on the job longer. But many times, these employees aren’t given extra time to do so; they still need to complete their own work. So they rush through the training, or leave it up to the new employee to ask questions.

Unskilled employees could spend considerable time seeking help to perform their jobs or they could perform tasks to their understanding, to the detriment of the work process. This could lead to errors and work needing to be repeated or corrected. When more experienced employees spend time monitoring unskilled workers, it detracts from their work and affects their production as well.

Unsafe Work Environment

The Occupational Safety and Health Administration states that “untrained workers are more susceptible to injuries. This happens when workers lack the knowledge and skills required to use equipment and supplies safely. The problem could be fatal in work environments that contain heavy-duty machinery and hazardous materials”. Again, the NHS is a prime example.

It isn’t enough to have established procedures and protocols for activities that involve potential safety risks. Employees must receive training on the appropriate procedures and how and when to use them. Supervisors need to ensure that all employees understand the protocols and demonstrate that they can follow them routinely. The introduction of new medical devices and/or procedures is a great example: an airline would NEVER let a pilot just take a new airplane model up full of passengers “to learn”. But in surgery, this happens every day, and injuries DO happen. More often, the patients outcomes are less that optimal. (read more about learning curves in surgery here and here)

Increased Expenses

A company that does not train its staff can expect an increase in a wide range of expenses, such as:

The cost of medical attention for staff because of injuries sustained from unskilled use of equipment and supplies;
Compensation to customers for defective products or treatments;
The cost of defending the company against lawsuits from employees who feel their injury was the result of inadequate training, or from patients who recieved suboptimal care or even sustained preventable injuries.

Loss of Customers

For businesses, untrained employees cannot produce high-quality products. If they also lack adequate knowledge and skills to provide satisfactory customer service, this combination results in dissatisfied customers. The company will experience declining sales if dissatisfied customers choose competitors who can provide quality products and appropriate service. For the NHS, patients will keep coming. But, for how long can we keep paying out billions to patients whom we have injured, before we have to fold?

When do we draw a line in the sand and say now we train on donated tissue, not on patients. When do we decide that we need to start certifying training for all new medical devices before allowing “tests” or “trials” on (often unaware) patients? Is it 2018? 2025? Or should we have done so years ago, when medical device innovation started coming faster and faster, and surgical observation and training time was dramatically reduced for junior doctors?

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